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首页> 外文期刊>The British journal of psychiatry : >Bifrontal, bitemporal and right unilateral electrode placement in ECT: randomised trial
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Bifrontal, bitemporal and right unilateral electrode placement in ECT: randomised trial

机译：ECT中的双额，双颞和右单侧电极放置：随机试验

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Background Electroconvulsive therapy (ECT) is an effective treatment for major depression. Optimising efficacy and minimising cognitive impairment are goals of ongoing technical refinements. Aims To compare the efficacy and cognitive effects of a novel electrode placement, bifrontal, with two standard electrode placements, bitemporal and right unilateral in ECT. Method This multicentre randomised, double-blind, controlled trial (NCT00069407) was carried out from 2001 to 2006. A total of 230 individuals with major depression, bipolar and unipolar, were randomly assigned to one of three electrode placements during a course of ECT: bifrontal at one and a half times seizure threshold, bitemporal at one and a half times seizure threshold and right unilateral at six times seizure threshold. Results All three electrode placements resulted in both clinically andstatistically significant antidepressant outcomes. Remission rates were 55% (95% Cl 43-66%) with right unilateral, 61% with bifrontal (95% Cl 50-71%) and 64% (95% Cl 53-75%) with bitemporal. Bitemporal resulted in a more rapid decline in symptom ratings over the early course of treatment. Cognitive data revealed few differences between the electrode placements on a variety of neuropsychological instruments. Conclusions Each electrode placement is a very effective antidepressant treatment when given with appropriate electrical dosing. Bitemporal leads to more rapid symptom reduction and should be considered the preferred placement for urgent clinical situations. The cognitive profile of bifrontal is not substantially different from that of bitemporal.
机译：背景技术电痉挛疗法（ECT）是治疗重度抑郁症的有效方法。优化疗效并最大程度地减少认知障碍是不断完善技术的目标。目的比较ECT中新型电极放置（双额）与两个标准电极放置（时空和右单侧）的疗效和认知效果。方法：这项多中心，双盲，对照试验（NCT00069407）从2001年至2006年进行。在ECT过程中，总共将230名患有严重抑郁症（双相和单相）的患者随机分配到三个电极位置之一：双前额叶癫痫发作阈值为一半，双时相发作为癫痫发作阈值的一半，右单侧发作为癫痫发作阈值的六倍。结果所有三个电极放置均导致临床和统计学上显着的抗抑郁效果。右侧单侧缓解率为55％（95％Cl 43-66％），双额叶缓解率为61％（95％Cl 50-71％）和64％（95％Cl 53-75％）（双时态）。在治疗的早期阶段，Bitemporal导致症状评级更快地下降。认知数据显示，在各种神经心理学仪器上的电极位置之间几乎没有差异。结论给予适当的电剂量后，每个电极放置都是一种非常有效的抗抑郁治疗方法。双颞可以更快地减轻症状，应被认为是紧急临床情况的首选治疗方法。双额叶的认知特征与双时相的认知特征没有实质性差异。

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